Preparing for E-Prescribing

SureScripts plans to launch its electronic prescribing gateway for pharmacies and physicians this quarter, along with regional market adoption programs, which will lead to widespread use of e-prescribing. The public unveiling of the company?s transaction engine follows avowals of support in recent weeks by a host of major pharmacy chains, which substantially advance SureScripts? goal of bringing pharmacy connectivity for e-prescribing to the marketplace.

SureScripts, in addition, this month expected to announce agreements with pharmacy system vendors through which independents will perform e-prescribing.

?We represent nearly 60% of the 55,000 pharmacies in America,? said SureScripts? chief executive officer, Kevin Hutchinson. ?After January, you will see that number rise dramatically.? The SureScripts engine will support transactions between enabled pharmacies and physicians nationally, starting in February. For growing e-prescribing volume, SureScripts will identify regions?or ?controllable markets??where it would have a critical mass of pharmacies. The regions will be the focus of intensive marketing, including, for example, direct marketing to physicians and pharmacists, seminars, grand-opening events, and ?light-up? ceremonies.

?In our opinion, the pharmacies have to be connected first. We would go into a region where 60% to 70% of the pharmacies are [ready],?? said Hutchinson.

?We are focusing very hard in the rollout on automating the script-renewal process??the biggest headache for pharmacies and doctors,? he continued. The percentage of new script orders will increase and, after several years, overtake refills, as physicians? systems are populated with patient information.

Hutchinson said that SureScripts might focus adoption campaigns on as many as 5 regions this year?after which e-prescribing should accelerate rapidly, fueled by word of mouth and the support of ?stakeholders.? These stakeholders include pharmacies, health care quality groups, technology vendors, health care plans and payers, and others who want e-prescribing to succeed.

Chain Links

Many chains, or their pharmacy systems vendors, will be writing software that SureScripts this year will begin to certify as compatible with its transaction engine, hosted and managed by pharmacy services provider National Data Corporation (NDC) Health Systems at its Atlanta data center (Table).

?Some of the chains have their own proprietary systems, and they will be writing their own code to the SureScripts? implementation guide following the NCPDP [National Council for Prescription Drug Programs] Script Standard,? said SureScripts? marketing consultant Tammy Lewis.

SureScripts? mandate has been to enable e-prescribing transactions without necessarily favoring any single pharmacy or physician system. That strict focus has won support from the chains, with which the company has worked closely, said Hutchinson.

?This is nothing but positive for the industry,? said Giant Food?s Manager of Pharmacy Systems Brad Dayton at the Landover, Md?based chain. ?More physicians will begin to do e-prescribing when more pharmacies have the capability to receive it. [Doctors are] not going to pay for an e-prescription service unless they can send to all of the pharmacies they work with,?? he added.

Given the overwhelming support it has received from pharmacies, Sure-Scripts will be integral to nationwide e-prescribing. The extent to which the SureScripts network is used will depend on how chains elect to perform e-prescribing.

Some chains are home-coding pharmacy systems to connect directly to the SureScripts engine. Chains might use pharmacy systems vendors such as QS-1, PDX, and TechRx with e-prescribing interfaces. Many chains will connect to SureScripts through NDC Health Systems, which, in a partner agreement, will use the company?s engine for e-prescribing.

?We will connect to NDC Health, and they can sell our transaction services to anyone they so desire,? said Hutchinson. NDC Health is selling an e-prescribing solution to the large base of pharmacies that use its TechRx pharmacy management system, and it is selling InstantDx?s OnCallData prescribing module to physicians, many of whom use its Medisoft and Lytec office management systems.

Connecting the Dots

SureScripts might be both an enabler and a competitor to an established e-prescribing company that has solutions for doctors, pharmacies, and the transactions between them. Expanded connectivity, on the one hand, is a boon to any system that connects to SureScripts. On the other hand, SureScripts provides alternative e-prescribing solutions to pharmacies and will claim a share of transaction revenues.

ProxyMed last month announced that Rite Aid would join chain customers, which include Walgreens and Eckerd, in interfacing with its Proxy-Net transaction engine for e-prescribing with doctors using ProxyMed solutions, such as Prescribe. The 1500 physicians who use ProxyMed solutions today?who are located in selected markets such as Florida, Texas, and Arizona, where it has a strong pharmacy base?swapped data with 6600 of 30,000 ProxyMed-enabled pharmacies in last year?s first quarter, said ProxyMed President Nancy Ham.

?We don?t have enough connectivity to roll this out nationally. Our challenge is to finish out the back end [the pharmacies] and concentrate our marketing where we have at least 60% pharmacy connectivity,? said Ham.

ProxyMed has an interconnectivity agreement with SureScripts, which should help ProxyMed bring pharmacies and doctors to markets on which it wants to focus. Physicians using Prescribe will be able to perform transactions with pharmacies other than the ProxyMed pharmacies, so long as those other pharmacies are linked with SureScripts.

Drugstore ChainsWalgreens, Eckerd, and Rite Aid may reach physicians who are using e-prescribe solutions other than Proxy-Med?s, through ProxyNet?s link with SureScripts, and those doctors linked with SureScripts can now reach those major chains (Figure). Those 3 chains, which have committed to support SureScripts, could develop direct links to SureScripts?or to NDC Health?which would bypass ProxyNet to reach physicians using systems other than ProxyMed?s.

?ProxyMed will continue to [market] its direct connections to pharmacies. If SureScripts adds on other pharmacies, that?s great,? says ProxyMed Executive Vice President for Prescription Services Jack Guinan. ?We all want the direct connections between pharmacies and doctors. But volume is the only way to succeed in this business. So these interconnec-

52 tions are all to the good,? Guinan added.

Supermarket Chain

Giant Food pharmacies since April ?in a system developed with NDC Health for its TechRx pharmacy-ware?have been swapping script data desktop to desktop, through connections with NDC Health with physicians using OnCallData?s Web-based model.

?We have configured this so we could work with other physicians? systems, if they conform to the Script Standard,? said Giant Food?s Dayton.

The NDC Health?SureScripts alliance will allow the pharmacies to reach an even larger pool of physicians. ?I want to be able to access every doctor that SureScripts can reach. I can go through NDC, or I might go directly through SureScripts,? said Dayton.

Communicating last year with 200 doctors using OnCallData, Giant Food had projected a refill-to-new-scripts ratio in the first year of 75% to 25%. ?When we began, the refills were driving it,? said Dayton.

?But doctors have become accustomed to using it, and new script transactions have increased significantly,? so that 42% of transactions are in new scripts, explained Dayton. ?This means, the physicians have adapted to and like the service they are being offered.? Presumably, more physicians will have reasons to like e-prescribing in the months and years ahead.